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Beyond Breast Vs. Bottle: It’s Time To Change The Conversation To Support

My first weeks on the job as the new Breastfeeding Promotion Program Manager at WithinReach and the article “Is Breast Truly Best? Estimating the effects of breastfeeding on long-term child health and wellbeing in the Unites States using sibling comparisons” was released by the journal Social Science and Medicine. Hold on. How is this even a question? As a public health dietitian who has focused her career on maternal and infant nutrition, I know that breast milk is the cornerstone of infant feeding.  And there are years of sound research to back me up. Yet somehow this one, single article was causing a media frenzy. The internet was buzzing with articles latching on (pun intended) to the idea that breastfeeding and bottle feeding are equivalent.

I decided to do some digging and read the original article along with many of the responses to it. It turns out there are some pretty significant limitations to the study which have been well described by several experts such as Dr. Alison Stuebe, Tracy Cassels, and Dr. Melissa Bartick and Dr. Briana Jegier. For example, the study did not define breastfeeding so we do not know how long a child is breastfed or if they were exclusively breastfed (we know however, that for most health outcomes impacted by breastfeeding, duration and exclusivity matter). Additionally, the study only looked at a very select few “long-term” health outcomes to the child, thus ignoring many well documented benefits to breastfeeding (such as positive impacts on blood pressure and type-2 diabetes) and completing disregarding well documented maternal health outcomes such as lower rates of certain cancers for mother who breastfeed.

Whew. The benefits of breastfeeding still prevail. Now that we’ve established that, let’s move onto the bigger picture here – the role many media sources played in spreading a not entirely true message. Many of the opinion pieces that were published about this article picked out a few findings from the study, but largely took them out of context and ignored some major conclusions that authors made. For one, the study actually found breastfeeding favorable results (see the reactions to this article linked above for details). Second, the authors also made an incredibly critical point – the need to take a look at the racial and socioeconomic disparities that exist around breastfeeding and make societal changes (i.e. systems level policy changes) to ensure breastfeeding success for all mothers. This means improved parental leave policies, better employer support, more affordable child care, higher wages, and improved access to health care (to name a few).  Those points were left out of most of the articles about the study.

As a breastfeeding mom, I can’t even imagine the impact this article might have had on other breastfeeding moms experiencing challenges or who are just getting started. Those first weeks can be vulnerable and are a critical time for establishing a successful breastfeeding relationship. We all have a responsibility to make sure the messages we share are sound. The systems and environments also need to be in place to support individuals, families and communities in achieving their optimal health. At WithinReach we are working towards this goal and each day move the dial to ensure health for all Washington families.

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